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In 1954, about 40 percent of Americans who were diagnosed with colon cancer could expect to live five years. By 2004, that figure rose to almost 70 percent. Today most early-stage colon cancers can be cured. Similarly, only 30 percent of those diagnosed with lymphoma in 1954 were alive five years later; today 90 percent of people who are diagnosed with Hodgkin’s lymphoma and 75 percent of those diagnosed with non-Hodgkin’s lymphoma can expect to be alive in five years, and the majority of patients can expect their tumors to be fully eradicated.

Similar trends hold up across almost all types of disease. They’re not confined to cancer, although that’s where some of our best historical reporting can be found, so those data are frequently cited. The mortality rate from stroke, the third most common cause of death, has declined by 75 percent since the 1960s. Between 1970 and 2005, the life expectancy of the average American increased by 6.6 years; 4.7 years of the increase is due to reductions in deaths from cardiovascular disease. Technology played a major role in these outcomes.

Increasingly, Medicare’s regulatory practices and its growing lists of rules are setting both a floor and ceiling on reimbursement levels for different sectors and different therapeutic settings and, in turn, the profits that can accrue to compensate entrepreneurs for risk taking. This is leading to an environment where innovation is increasingly being contrived to fit within a narrow set of parameters set out by policy prerogatives, rather than the opportunities offered by science, and the clinical aspirations of patients.